The capital's Social Insurance Fund clarified how to calculate benefits if there is a note on a violation of the regime on the sick leave

What are the types of sick leave violations?

The answer to this question is contained in Article 8 of the Law “On Compulsory Insurance” dated 2912.2006 No. 255-FZ. Violations of the sick leave regime that have consequences at work include:

• Failure of the sick person to comply with the disease and treatment regimen prescribed by the doctor. There is an important “without reasonable cause” clause in the law;
• Failure of a sick person to attend a scheduled medical examination or medical examination;
• The illness (or injury) being treated occurred as a result of the sick person being drunk. Intoxication can be of any kind - alcohol, drugs, etc.

With the last two points everything is more or less clear. At the moment when the employee submits sick leave for payment, the document will already have the corresponding marks and the accountant will only have to recalculate the sick leave benefit according to the minimum wage (clause 2 of Article 8 of Law No. 255-FZ).

It becomes more difficult when the regimen is not followed due to reasons that may be assessed differently by the employee’s management and his attending physician. For example, when a patient is prescribed bed rest and goes to work. For the employer, the reason may be valid. And for a doctor? As we can see from the table, most likely not. For going to work, the doctor will mark you for violating the regime. And this means that the benefit for such sick leave will be reduced.

How to pay for sick leave if it was violated for a good reason?

At the place of work, the employee must provide an explanatory note explaining the reasons for non-compliance with the regime. A special commission created by the employer or the social insurance commissioner makes a decision on the payment of benefits.

Important: a note about violation of the hospital regime is not a basis for closing the sick leave.

What are they?

The legislation of the Russian Federation does not have a clear list of valid reasons for non-compliance with the hospital regime. You can focus on the order of the Ministry of Health and Social Development dated January 31, 2007 N 74 “On approval of the list of valid reasons for missing the deadline for applying for benefits for temporary disability, pregnancy and childbirth, monthly child care benefits”, which states that valid reasons include:

• natural disasters;
• moving a person to another locality;
• serious illness or death of a close relative of the patient;
• forced absenteeism due to illegal dismissal or suspension from work;
• other reasons recognized as valid in court.

Often the FSS does not recognize the reasons for the violation as valid and does not agree with the decision of the social insurance commission. The main reasons for refusal are:

• lack of supporting documents to recognize the reason as valid;
• the meeting of the commission was carried out formally;
• errors in papers and documents.

If all documents are filled out correctly and the valid reason is proven, then the FSS cannot refuse payments. If such a situation occurs, then the fund’s decision can be appealed in court or higher authorities of the FSS of Russia.

Calculation of funds on a certificate of incapacity for work

If it is proven that the sick leave regime has been violated for good reason, then the amount of benefits is calculated in the usual way based on the employee’s average salary. To determine it, wages for the previous 24 months are summed up and divided by 730.

Depending on the length of service, the benefit amount is:

• 60% – less than 5 years;
• 80% – from 5 to 8 years;
• 100% – more than 8 years.

Example: Sick leave was opened on February 10. An appointment with the doctor is scheduled for the 15th. For good reason, the employee visited the doctor only on the 16th. The document with a violation mark was extended and closed on February 18. The employee’s monthly salary over the past two years was 25 thousand rubles.

25000*24/730=822 rubles – average daily earnings.

His work experience is more than 10 years, which means that the benefit amount is calculated at 100%.

822*9=7398 rubles – payment to an employee under the BL.

Preparation of documentation and important points in filling it out

There are several types of violation of hospital regulations, which are recorded in the corresponding line of the BC with a specific code:

• code 23 – violation of medical instructions;
• code 24 – untimely visit to the doctor;
• code 25 – early return to work;
• code 26 – refusal to take tests and undergo examination;
• code 27 – missed or late medical examination;
• code 28 – other violations.

Read more about how to pay for a ballot marked 24, 25 and other numbers here.

After the digital mark, the date of the violation and the doctor’s signature are placed ((you can find out what a note about a violation of the regime on a sick leave certificate means and what the consequences of paying for such a document are here).

The sick leave form must be filled out without errors or corrections. Also, you cannot go beyond the permissible limits - in this case, the document may be declared invalid.

The procedure for paying sick leave in violation of the regime

The first document that needs to be issued for sick leave with a note about violation of the regime is an explanatory letter from the employee regarding the violation of the regime. It is not difficult.

The second document is the minutes of the meeting of the employer’s social insurance commission with a decision on whether the reasons for violating the regime are valid or not. The creation of the commission is provided for by the regulations of the FSS (regulations on the commission approved by the FSS on July 15, 1994 No. 556a). In practice, such commissions are rarely created. However, their absence is not penalized in any way.

If there is no commission, it is still recommended to record in writing the employer’s opinion on whether the reason for violating the sick leave regime is valid. For example, an order from the director: “the reason is disrespectful, pay benefits according to the minimum wage.” As practice shows, for the FSS, a selection from the explanatory note and such a second document is often sufficient.

For violations related to non-compliance with the prescribed treatment regimen and examinations, the minimum wage benefit is calculated from the date of such violation (will be indicated on the sick leave).

For being on sick leave as a result of intoxication, the entire period indicated on the sick leave should be calculated according to the minimum wage.

Previous position

The authors of the letter considered the following situation.
The employee was on sick leave from April 17 to April 24, 2021. Due to a late appearance for an appointment with a doctor, a note about violation of the regime was placed on the certificate of incapacity for work (code “24” - failure to appear for an appointment), dated 04/21/2020. In the “Other” line, code 36 “Apparently able to work” and the date 04/24/2020 are indicated. How to pay for such sick leave? Previously, the Moscow branch of the FSS stated that for the period from April 17 to April 20, sick leave is paid according to the general rules, and for the period from April 21 to April 24 (from the date of violation to the date of closure of the sick leave) - based on the minimum wage (letter dated June 11, 2020 No. 14 -15/7710-2216l). Note that similar explanations were given in the letter of the same department of the Social Insurance Fund dated December 7, 2018 No. 14-15/7710-3598l (see “The sick leave note contains a note about violation of the regime: how to calculate the benefit?”).

Payment of sick leave in violation of the regime for reasons valid for the employer

The most common question that arises when paying for sick leave is what to do if an employee violates the regime by going to work at the request of management? Read about whether this is permissible from the point of view of labor legislation here

Should sick leave benefits be reduced for such a responsible employee? There are certain difficulties here.

In the event of a return to work agreed upon with management, the employee may not notify the doctor about this and will bring a certificate of incapacity for work, in which there will be no notes on violation of the regime. But the accountant will know for sure that going to work without an extract is a violation. And the employee definitely came out (documents are available). And the FSS needs to be notified that during the period of incapacity there were working days that were not included in the calculation of benefits.

What should an accountant do? The existing judicial practice does not provide a clear answer to the question of what to do in such a situation. There are both decisions in favor of the Social Insurance Fund, which refused to reimburse benefits not in accordance with the minimum wage, paid in case of violation of the sick leave regime, and decisions in favor of workers who did not agree with the payment of sick leave with violations of the minimum wage.

Therefore, in practice, an accountant, with the participation of a manager, most often makes a compromise decision. The benefit will still be reduced, and the employee’s conscientiousness will be encouraged in other ways.

Calculation of temporary disability benefits in case of violation of the regime

In case of violation of the regime during illness, a special procedure for calculating benefits is provided. The regime is determined by the doctor who opened the sick leave. For failure to comply with the requirements, a reduction in disability benefits is provided (Part 1, Article 8 of Law No. 255-FZ).

The following table shows possible violations with classification codes that doctors use when issuing certificates of incapacity for work (Order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n).

Below is a fragment of a sick leave note with a note about non-compliance with the regime. When recording a violation, the doctor enters the appropriate code and date.

Regarding the payment of sick leave in violation of the treatment regimen, the Letter of the GU-MRO FSS of Russia dated September 01, 2020 No. 14-15/7710-2216l was recently issued, in which the FSS changed its position. For comparison, consider the old and new procedures for paying sick leave in case of violation of the regime.

Old order

If there is a note about the violation on the sick leave, payment for days of incapacity for work consists of two components:

• before violation of the regime - payment in the usual manner;
• from the date when the regime was violated - according to the minimum wage.

Example 1

The patient was issued a certificate of temporary incapacity for work from September 1 to September 14, 2021. On September 11, he did not show up for his appointment, which the doctor noted. The employee's work experience is 6 years (benefits amount is 80%). Earnings for the previous 730 days - 1,249,730.8 rubles, in terms of 1 day - 1,711.96 rubles.

We calculate the allowance:

• from September 1 to September 10—RUB 1,711.96. * 10 days * 80% = RUB 13,695.68;
• from September 11 to 14 - 12,130 rubles. / 30 days * 4 days = 1,617.33 rubles.

Total - 15,313.01 rubles.

But in the absence of the “insidious” mark on the sick leave, the payment would have been significantly more - 1,711.96 * 14 days * 80% = 19,173.95 rubles.

As you can see, the reduction in the amount of benefits is significant, so organizations are looking into the reasons for the violations. And if they are caused by objective circumstances, sick leave is paid in full.

Since, starting from the 4th day, the benefit is paid by the Social Insurance Fund, it is important to formalize the decision on full payment correctly: the employee writes an explanatory note indicating the code and reasons for the violation, and the employer, recognizing the reasons as valid or not, issues an appropriate order.

Sometimes, at a meeting of the labor collective, a commission is elected, including representatives of the trade union organization. In this case, the decision is formalized by an act:

New order

Now let’s see what FSS Letter No. 14-15/7710-2216l says about paying sick leave in case of violation of the regime. In it, the FSS analyzes the situation regarding the calculation of sick leave in the presence of a violation under code 24 (failure to show up to the doctor at the appointed time). If the patient did not come to the appointment and did not continue treatment, on the sick leave, instead of the date of return to work, the doctor enters code 36 in the “Other” line:

Benefit calculation:

• days before the doctor's note - as usual;
• the day on which the regime was violated - according to the minimum wage;
• the following days until the end of the sick leave - without payment.

Following the conditions of our example, the benefit will be 13,695.67 rubles. + 12,130 rub. / 30 days * 1 = 14,100.01 rub.

Considering days of violation as absenteeism or forced absence from work is a decision of the employer made after identifying the reasons for failure to appear at the doctor.

How can I pay for violation of the sick leave regime?

If an employee returned to work from sick leave at the request of management, then management’s task is, at a minimum, not to worsen the employee’s situation.

An economical option that can satisfy both the employee and the employer is this: when leaving an open sick leave, the employee is paid the salary for the days of leave. The sick leave benefit for the Social Insurance Fund is reduced from the date of the “violation” (date of withdrawal). At the same time, the benefit that would have been paid without violations is calculated and the difference between the second and first is paid to the employee by the organization. Remember that insurance premiums must be calculated from such additional payments, because it will be considered payment within the framework of the employment relationship.

Material aid. Instead of additional payment for sick leave, the employee can be paid financial assistance due to illness (very appropriate). In this case, the amount of assistance may even exceed the amount of benefits that would be received on sick leave.

Prize. This is also an option when benefits for the Social Insurance Fund are reduced due to violations of sick leave, but the employee’s work zeal must be encouraged. It should be remembered that you should not assign a bonus immediately after starting work. This will raise questions among various inspectors. It is better, in agreement with the employee, to pay him a bonus a little later. For example, at the end of the quarter in which he was sick.

How is sick leave paid in general?

Sick leave benefits are determined based on the employee’s length of service and average earnings. The dependence of the value on length of service is shown in the table:

The calculation is made on the basis of the employee’s average earnings for the last 2 calendar, fully worked years, i.e. for 730 days (Clause 1, Article 14 of the Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability...” ). All payments for which contributions to the Social Insurance Fund were calculated are taken into account.

From April 1, 2021, sick pay should not be less than the minimum wage in terms of the number of days of illness, regardless of length of service and amount of earnings (Law No. 104-FZ dated April 1, 2020 “On the specifics of calculating benefits for temporary disability”).

This rule was adopted to support workers with short experience during the coronavirus epidemic and is valid until December 31, 2020. The minimum wage benefit in terms of one day for each month is calculated separately by dividing the established amount by the number of days in the month.

Results

Violation of sick leave entails recalculation of benefits not according to average earnings, but according to the minimum wage.
If an employee violated the regime in favor of the employer, for example, went to work on sick days, the violation remains a violation. To avoid problems with the Social Insurance Fund, it is better to recalculate the benefit. And in order to maintain a good relationship with the responsible employee, you can find a way to compensate him for lost benefits and provide additional incentives. You can find more complete information on the topic in ConsultantPlus. Free trial access to the system for 2 days.

What the law says

However, this conclusion is controversial. The list of grounds for reducing the amount of sick leave benefits is listed in the article of the Federal Law of December 29, 2006 No. 255-FZ. In particular, it says that in case of violation without good reason of the regime prescribed by the attending physician, or failure to appear without good reason for a medical examination, the benefit is paid in an amount not exceeding the minimum wage for a full calendar month, “from the day on which the violation was committed.” , and not for the day when the violation occurred (failure to appear at the doctor).

What reasons for violating the rules are considered valid, and who decides whether the employee had valid reasons for failing to show up for an appointment? The capital's FSS notes that the legislation of the Russian Federation does not contain a list of such reasons. The decision as to whether the reason was valid lies within the competence of the medical institution where the certificate of incapacity for work was issued, and the attending physician directly.

The sick leave note indicates a violation of the regime: legal consequences

If 1 or more of the above codes includes sick leave, the consequences of violations of the treatment regimen that correspond to these codes will most affect the interests of the employee who committed these violations.

The fact is that his allowance for temporary working capacity in this case will be calculated at a minimum amount - based on the minimum wage. In this case, the moment of committing the action that gives rise to sanctions may be important, as well as the basis for reducing benefits based on the fact that:

1. For violations with codes 23, 24, 25, 26, 27, sick leave is calculated in the minimum amount from the date of the violation.

2. If there is code 021 on the certificate of incapacity for work, the benefit is calculated in the minimum amount for the entire period of temporary incapacity for work.

An example of calculating sick leave when an employee violates the regime from ConsultantPlus Romantsova I.M. sick leave was issued in connection with being in hospital due to illness (cause of disability code “01”). The sick leave was issued for the period from January 21 to January 25, 2021 (5 days). Due to the fact that the employee left the hospital without permission, the doctor entered the code “23” in the line “Notes on violation of the regime” and indicated the date of the violation - 01/22/2021. Explanations about the reasons for violating the regime of Romantsov I.M. didn't introduce it. Payments for the billing period for which insurance premiums for VNiM are calculated - RUB 1,204,500. The employee's insurance experience is 19 years and 5 months. The calculation of temporary disability benefits until the day of the violation is as follows... You can view the full example in K+, having received free trial access to the system.

At the same time, the employer, before reducing sick leave, must have evidence that violations under paragraph 1 were committed by the employee without a good reason.

The fact that certain codes are indicated on the sick leave is only the basis for calculating sick leave in a reduced amount, but does not give the company the right to unconditionally apply the appropriate mechanism for reducing the amount of benefits.

Let's consider how an employer can determine whether an employee's violation of a treatment regimen is due to a valid reason or not.

Filling out sick leave by the employer with a violation of the regime and indicating code 36

/ 730 days) × 7 days = 3835.62 rubles;

Important

: if there were 30 days in a month, then the minimum wage is divided by 30. If the period after the fact of the violation affects 2 months, then a
separate calculation
. Let’s say the violation occurred on August 31, 2021, in this case the calculation will be carried out on the basis of one day in August and two days in September:

• (7800 rub. / 31 days × 1 day) + (7800 rub. / 30 days × 2 days) = 251.61 rub. + 520 rub. = 771.61 rub.;
• total benefit amount if there are 31 days in a month: 3835.62 rubles. + 754.84 rub. = 4590.46 rub.

It is obvious that violation of the sick leave regime quite significantly affects the material interests of the violator.

In accordance with paragraph 5 of the Procedure for issuing certificates of incapacity for work, approved by order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n, the issuance and extension of certificates of incapacity for work is carried out by a medical worker after examining the citizen and recording data on his state of health in the medical record of an outpatient (inpatient) patient, justifying the need for temporary release from work.

According to Part 8 of Article 6 of the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity”, temporary disability benefits are paid to the insured person for calendar days falling on the corresponding period, for with the exception of calendar days falling within the periods specified in Part 1 of Article 9 of the said Law.

Taking into account this definition and the provisions of Article 13 of Federal Law No. 255-FZ of December 29, 2006, temporary disability benefits paid on the basis of a certificate of incapacity for work are calculated for calendar days falling on the period of temporary disability specified in a specific certificate of incapacity, which is calculated from the first to the last entry in the table “Exemption from work”, i.e. the period when the citizen was examined by a doctor.

Including a period of temporary disability on the certificate of incapacity for work when the citizen was not examined by a medical professional and was declared able to work at the next visit to the doctor, as in the first example, is unjustified, since this requirement is not provided for by the Procedure.

At the same time, if, after an untimely visit to the doctor, a citizen is still recognized as incapacitated at the next visit to the doctor, then the period of failure to appear to the doctor is entered on the certificate of incapacity for work. This is due to the fact that, in accordance with the decision of the medical commission, in this case the provisions of paragraph 14 of the Procedure can be applied and the issuance of a certificate of incapacity for outpatient treatment is carried out with the inclusion of the past days in the “Exemption from work” table.

Otherwise, if the period of non-appearance is not written down in the certificate of incapacity for work, then the citizen who appears for the next examination by a doctor and remains disabled will not be paid benefits for the period of non-appearance, which is a violation of the norms enshrined in Articles 7 and 8 of the said Law.

Registration of a certificate of incapacity for work in the event that a citizen, after the issuance or extension of a certificate of incapacity for work, does not appear for an appointment, is carried out in accordance with Chapter IX of Procedure No. 624n. If at the next visit the citizen was recognized as able to work, the code “24” is indicated in the “Notes on violation of the regime” line of the certificate of incapacity for work, the date of untimely attendance at the doctor’s appointment is indicated in the “Date” line, the corresponding code is indicated in the “Other” line in the corresponding cells “36” and the date of appearance as able-bodied.

If the citizen is incapacitated for work, then the specified code “36” is not entered on the certificate of incapacity for work and the line “Other” with the allocated cells is not filled in.

In these cases, the provisions of paragraph 2 of part 1 and paragraph 1 of part 2 of Article 8 of the Federal Law of December 29, 2006 No. 255-FZ are applied, according to which in the event of failure of the insured person to appear for a medical examination on time without good reason, the amount of temporary disability benefits , assigned for the period from the day on which the specified violation was committed and until the end of the period of incapacity is limited to the minimum wage for a full calendar month (in the first case, from February 20 to 23, the benefit is calculated from the minimum wage, in the second - from February 20 until recovery ).

It should be taken into account that the basis for reducing benefits is the failure of the insured person to appear on time for a medical examination or for a medical and social examination without good reason.

What does code 36 on a sick leave mean?

Therefore, the clinic must issue a certificate of incapacity for work and discharge the citizen to work from the date following the date of the scheduled appearance at the clinic, putting code 24 - “late appearance for an appointment with a doctor” and in the line “Other” code 36 - “appeared able to work.”

Thus, the days following the date when the employee was supposed to see a doctor do not belong to the period of temporary incapacity for work. Attention: Several cells are allocated for them:

two – the code itself (from 01 to 15); three – to indicate an additional cipher (017-021); two – the changed code is recorded here, if necessary (the diagnosis has been clarified).

There are several purposes for using codes, in particular: Compact and economical use of the form. Simplifying and optimizing the work of HR staff.

There is no need to understand the doctor’s often “unreadable” handwriting.

How is sick leave paid if there is a gap in the sick leave certificate with a note about violation of the regime with code 24?

1 tbsp. 8 of Law N 255-FZ does not contain a requirement that the failure of the insured person to appear on time for a medical examination entails a reduction in the amount of temporary disability benefits from the day on which the violation was committed for the entire period of incapacity. When punishing a guilty employee, the principle of proportionality must be taken into account, which involves establishing responsibility only for a guilty act and its differentiation depending on the severity of the act, guilt and other significant circumstances that determine individualization when applying measures of responsibility.

The Supreme Arbitration Court of the Russian Federation clarified that only a reduction in the amount of benefits for the period until the next appearance for examination can be considered fair. If, after the violation, the employee regularly visited the doctor, the amount of his benefit should return to its original value. Presidium of the Supreme Arbitration Court of the Russian Federation (see.

How is sick leave paid in case of violation of the regime?

If an employee violates the regime for an unjustified reason, the amount of temporary disability benefits is reduced. From the date of failure to attend an appointment or other violation, benefits are paid in an amount not exceeding the minimum wage for a calendar month (clause 1, part 2, article 8 of Law No. 255-FZ, clause 22 of Regulation No. 375). From January 1, 2021, the federal minimum wage is 12,130 rubles. In regions and localities where regional coefficients apply, the minimum wage indicator increases by the amount of the specified coefficient.

The payment is calculated according to the following scheme:

Maximum benefit in case of violation of the regime = minimum wage in the month of illness / Number of days in the month of illness * Days of illness from the day of violation of the regime.

Question answer

When will they start paying sick leave according to the new rules? For example, an employee’s earnings for 2018-2019 amounted to 523,780 rubles and 740,552 rubles. respectively. The total work experience is 11 years, so disability benefits should be accrued in the amount of 100% of average income. The employee was sick for 10 days - from June 12 to June 21 - but during this period he violated the regime. On June 16, he did not show up for a doctor’s appointment, and only came on June 19.

To calculate sick leave, the employee’s average daily income is first calculated based on his income for 2 years. It is equal to 1,731.96 rubles. ((523,780 + 740,552) / 730). In the period from June 12 to the 15th (before the date of violation, that is, 4 calendar days), payment is made according to average earnings: 6,927.84 rubles. (1,731.96 x 4). From the day of failure to appear until the date of discharge (6 days), accruals will be made according to the minimum wage. They will amount to 2,426 rubles. ((12,130 / 30) x 6, where 30 is the number of days in June). The total amount of the benefit will be 9,353.84 rubles. (6,927.84 + 2,426). If the employee had not violated the rules, the payments would have amounted to 17,319 rubles.

How to pay for sick leave, taking into account the need to justify the amount of benefits

The best option is if the decision on whether or not the employee’s violation of the treatment regimen is due to valid reasons is made collectively in the company. For these purposes, the organization can establish a special commission on social insurance issues - permanent or temporary (convened from time to time).

This commission may decide to recognize the reasons for the violation as valid:

1. Based on the content of the explanatory note requested from the employee. At the same time, since the formation of this note is not regulated by the Labor Code of the Russian Federation, the employee may refuse to provide it.

2. Based on information provided in writing by other employees (including if the employee refuses to provide an explanatory note).

3. Based on the actual circumstances of the violation established by the commission.

4. Taking into account the proportionality of the actual violation (taking into account the identified circumstances of its commission) and the employee’s possible material losses (which may be much greater than the employer’s losses - due to the fact that the main part of the sick leave is paid by the Social Insurance Fund).

We remind you that starting from 2021, the employer accrues and pays benefits only for the first 3 days of sick leave due to illness or domestic injury. The rest of the benefit amount is calculated and paid to the Social Insurance Fund employee, and some benefits are paid by the fund 100%. For more information, see our guide to direct benefit payments.

At the same time, even if the decision is made in favor of the employee, the Social Insurance Fund, nevertheless, based on the fact that the sick leave contains violation codes, may refuse full payment of disability benefits if it recognizes the commission’s conclusions as unfounded.

This decision of the commission, one way or another, is important to document. Alternatively, in a special act. Let's study its features.

Is it possible to pay benefits without limiting the amount?

If the reason for violating the regime was sufficiently compelling and justified, then the sick leave benefit can be transferred in full. Making this decision is the responsibility of the social insurance commissioner in the subordinate’s company. This may be the manager or a person appointed by the manager.

In this case, in the line of the sick leave “Terms of payment”, you must enter code 48. A written explanatory note from the subordinate, as well as an order about the absence of restrictions on payments, should be attached to the document.

The compelling circumstances explaining non-compliance with the sick leave regime include the following factors:

• the subordinate suffered from natural disasters - for example, from a flood, fire, hurricane;
• the subordinate suffers from a serious illness that lasts 6 months or more;
• the subordinate changed his place of residence and moved to another region;
• serious family circumstances have arisen in a person’s life - for example, a serious illness of a loved one or his death.

The subordinate’s explanatory note must contain not only a detailed reason for non-compliance with the sick leave regime, but also evidence. For example, if a subordinate who is on sick leave has a small child who falls ill, as a result of which she was forced to miss a visit to the doctor, then this is a valid reason. You can prove it with a certificate of a therapist’s visit to the subordinate’s home to examine the child. At the same time, practice shows that the illness of a family member is a rather controversial issue, and a subordinate may have problems receiving the full portion of sick leave payments.

Explanatory note from an employee about the reasons for violating the hospital regime (sample)

As for the reimbursement of benefits from the Social Insurance Fund, in this case difficulties may arise. If social insurance employees consider that the reason for non-compliance with the regime is not sufficiently justified, then the subordinate risks being denied compensation. If you have any questions, you should contact the territorial office of the FSS in your region and get professional advice.

Valid and disrespectful reasons for violating the regime

The employer, at its discretion, may consider the reasons for the employee’s violation of the sick leave regime as valid, but he is not obliged to be guided by the generally accepted list of such reasons. So, in most cases, the following are considered valid reasons:

• illness or death of a close family member;
• moving to a permanent place of residence in another locality, changing the place of temporary residence;
• long period of temporary disability - more than six months;
• the presence of force majeure circumstances (fire, flooding, military action, natural disaster).

If the employer or judge finds the reasons why the doctor's orders were violated to be unjustified, the amount of sick leave benefits will be reduced. If so, then the amount of sick leave benefits will be calculated based on the current minimum wage from the date the violation was noted.

Disability codes on sick leave

In this case, the benefit is paid from the funds of the Social Insurance Fund and is counted towards the payment of contributions.

Disease codes on sick leave mean the following: Code on sick leave What does it mean 01 Disease 02 Injury 03 Quarantine 04 Accident at work or its consequences 05 Maternity leave 06 Prosthetics in hospital 07 Occupational disease or its exacerbation 08 Aftercare in a sanatorium 09 Care for a sick family member 10 Other condition (poisoning, manipulation, etc.) 11 Disease specified in paragraph 1 of the List of socially significant diseases approved (for example, tuberculosis, hepatitis B, C, diabetes mellitus, etc.) 12 This code is indicated , if the sick leave was issued due to the illness of a child under 7 years of age and his illness is included in a special list () 13 This code is reflected in the sick leave if it is issued

How to record a violation of the regime

The first and main authority that can indicate an employee’s non-compliance with sick leave rules is his attending physician. Then there are 2 options: either the employer personally determines the degree of guilt

its employee, or
a special commission
, which establishes this collectively. As a rule, such a temporary or permanent commission on social issues. insurance is created from representatives of the organization's management and trade union members by elections at a general meeting of the labor collective.

The Commission has the right to legally

determine whether the reason for non-compliance with the regime by a particular citizen is valid or not. The obligation to create such a commission is not determined at the legislative level, but recognition of the violation as disrespectful on its own can be challenged by the labor inspectorate.

Therefore, in order not to provoke additional inspections by the labor inspectorate and the Social Insurance Fund, it is necessary that all decisions and actions to reduce temporary disability benefits be formalized correctly. To do this, you need to know how to record a violation

sick leave in accordance with current legislation.

Registration of the act

This document must reflect the following points:

• indication of the two-digit code of the violation that occurred;
• description of the circumstances of the incident;
• a brief content of the citizen’s explanatory note indicating that it is attached to the act being drawn up;
• information about the members of the commission (names and positions held);
• information about available witnesses (if there were any);
• decision made by the commission;
• signatures of all commission members with transcripts;
• date of document execution.